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"The increasing prevalence of obesity in many countries means that it should now be considered a pandemic. It is widely recognized that obesity increases the risk of a variety of life-threatening conditions, including heart disease, diabetes, and hypertension. Bariatric surgery is often the most effective way to treat such morbid obesity. Nevertheless, while various bariatric procedures have been proposed, to date standards have been lacking. In this book, leading experts from around the world discuss all aspects of bariatric surgery and present their own favored versions of surgical procedures with the aid of informative illustrations. Technical nuances are carefully described, and detailed attention is devoted to potential complications and how to avoid them. "

"ABSTRACTPurposeLysophosphatidylcholine (LPC), which is generated from phosphatidylcholine (PC) and metabolized by autotaxin (ATX), modulates immune responses via its anti-inflammatory property. We investigated the association between LPC and postoperative complications (POCs) after colorectal cancer surgery (CRC).MethodsThe subjects of this study were 43 patients who underwent surgery for CRC. Peripheral blood samples were collected preoperatively and immediately after surgery, and on postoperative days (PODs) 1, 3, 5, and 7. Patients were divided into a No-POC group (n = 33) and a POC group (n = 10). Blood LPC, IL-6, PC, and ATX levels were measured by specific enzymatic assays or ELISA.ResultsThe postoperative to preoperative LPC ratios were lowest on POD 1 in both groups. The POC group had significantly lower LPC ratios throughout the perioperative period than the No-POC group. The LPC ratios were inversely correlated with IL-6. The predictive impact of LPC ratios on POCs was demonstrated by ROC analysis (cut-off 51.2%, AUC 0.798) and multivariate analysis (OR 15.1, P = 0.01). The postoperative PC ratios decreased more after surgery in the POC group. ATX levels did not change significantly in either group.ConclusionsDecreased postoperative LPC is associated with increased postoperative inflammatory response and POCs. The decreased PC supply to the circulation is a mechanism of the postoperative LPC decrease."

"The demand for cosmetic procedures is increasing worldwide. This book presents all the potential side-effects and complications of the most frequently used procedures in aesthetic dermatology and provides sound practical advice on their management. It will be helpful not only to beginners but also to experienced dermatologists who want to start performing new procedures. The text is fully illustrated and very simple to consult. For each procedure, the book discusses both common and uncommon side-effects and complications, provides tips on how to avoid them, and explains clearly how they are best treated."

"Latar Belakang Malformasi arteri-vena (MAV) adalah kondisi di mana arteri dan vena terhubung langsung tanpa pembuluh kapiler. MAV otak memiliki risiko tinggi untuk perdarahan yang berpotensi fatal. Insiden MAV otak berkisar antara 1.12 hingga 1.42 kasus per 100,000 orang per tahun, dengan tingkat mortalitas sekitar 10-15%. Tujuan penelitian ini adalah untuk menyediakan hasil studi mengenai perbaikan pasien MAV otak pasca SRS di RSUPN Dr. Cipto Mangunkusumo, Jakarta. Harapannya, dapat memberikan wawasan yang berharga dalam memperlancar penanganan kondisi ini. Metode Penelitian ini adalah penelitian observasional deskriptif dengan jenis studi kuantitatif. Pasien yang diteliti adalah pasien yang dirawat dengan SRS di RSCM, dan terdata dalam kurun tahun 2018-2023. Waktu follow-up pasien adalah 3 tahun. Luaran klinis yang dinilai adalah sefalgia dan kejang. Luaran lainnya adalah radiologis, dan komplikasi pasca-tindakan SRS. Hasil Penelitian dilakukan pada 41 pasien (63.4% laki-laki, 36.6% perempuan, rerata usia 25.7 tahun; usia minimum 5 tahun, dan usia maksimum 72 tahun). Seluruh pasien (41 orang) mengalami sefalgia sebagai manifestasi awal, dan seluruh pasien mengalami perbaikan pada masa follow-up 1 tahun. Kejang merupakan manifestasi terbanyak kedua (15 orang), dan perbaikan kejang mencapai 86.7% pada masa follow-up 1 tahun. Manifestasi lainnya adalah defisit motorik, gangguan bahasa, gangguan memori, dan gangguan lapang pandang. Komplikasi pasca-tindakan yang terjadi pada pasien adalah edema serebri dan perdarahan. Kesimpulan Seluruh pasien (41 orang) MAV otak mengalami perbaikan sefalgia, hal ini tercatat pada masa follow-up 1 tahun. Pada masa follow-up 2 tahun, 86.7% pasien mengalami perbaikan kejang dari total 15 pasien MAV dengan manifestasi kejang. Semakin kecil volume nidus MAV, maka semakin besar obliteration rate. Komplikasi terbanyak yang dialami oleh pasien MAV otak yang ditatalaksana dengan SRS di RSCM adalah perdarahan, dengan angka 9.8% (4 orang).

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Introduction Arteriovenous malformation (AVM) is a condition where arteries and veins are directly connected without capillaries. Brain AVM carries a high risk for potentially fatal bleeding. The incidence of BAVM ranges from 1.12 to 1.42 cases per 100,000 people per year, with a mortality rate of approximately 10-15%. The aim of this study is to provide the results of a study on the improvement of cerebral MAV patients after SRS at Dr. Cipto Mangunkusumo Hospital, Jakarta. Hopefully, it can provide valuable insights in expediting the management of this condition. Method This study is a descriptive observational study with a quantitative study type. The patients studied were patients who were treated with SRS at RSCM, and were recorded in the period 2018-2023. Patient follow-up time was 3 years. The clinical outcomes assessed were cephalgia and seizures. Other outcomes were radiological, and post-treatment complications of SRS. Results The study was conducted on 41 patients (63.4% male, 36.6% female, mean age 25.7 years; minimum age 5 years, and maximum age 72 years). All patients (41 people) had cephalgia as the initial manifestation, and all patients had improvement at the 1-year follow-up period. Seizures were the second most common manifestation (15 patients), and seizure improvement was 86.7% at 1-year follow-up. Other manifestations included motor deficits, language impairment, memory impairment, and visual field impairment. Post-operative complications that occurred in patients were cerebral edema and hemorrhage. Conclusion All patients (41 people) with cerebral MAV experienced improvement in cephalgia, this was noted at the 1-year follow-up period. At the 2-year follow-up period, 86.7% of patients had seizure improvement out of a total of 15 MAV patients with seizure manifestations. The smaller the MAV nidus volume, the greater the obliteration rate is. The most common complication experienced by brain MAV patients who were treated with SRS at RSCM was hemorrhage, with a rate of 9.8% (4 people)."

"This handbook is aimed at first-line health care providers involved in the perioperative care of adult and pediatric neurosurgical patients. It is unique in its systematic focus on how to deal with common and important clinical challenges encountered in day-to-day practice in the OR, the PACU, and the ICU and is designed as a problem-solving tool for all members of the perioperative medicine team: trainees and faculty in anesthesiology, neurosurgery, and critical care; nurses; nurse anesthetists; and physician’s assistants. • Encompasses clinical continuum from neurosurgical pre-op to critical care – plus anesthesia in neuroradiology• Adult and pediatric care• Structured algorithmic approach supports clinical decision-making• Succinct presentation of clinically relevant basic science• End-of-chapter summaries, with suggestions for further reading• Collaborative approach and multidisciplinary nature of perioperative medicine emphasized• Extensive summary tables• Portable and formatted for quick retrieval of information• Ideal for use in the OR, the PACU, and the ICU"

"Latar Belakang: Pembedahan saluran cerna memiliki risiko komplikasi tinggi yang meningkatkan morbiditas, mortalitas, dan biaya kesehatan. Penurunan albumin pascaoperasi terkait inflamasi sistemik menjadi indikator penting komplikasi. Comprehensive Complication Index (CCI) digunakan untuk menilai komplikasi lebih komprehensif dibanding Clavien-Dindo Classification.Metode:Studi kohort prospektif ini dilakukan di RSUPN Cipto Mangunkusumo pada Juli-November 2024. Subjek penelitian adalah pasien dewasa yang menjalani pembedahan saluran cerna. Dari 80 subjek awal, 78 memenuhi kriteria dengan 39 pada kelompok albumin dibawah rata-rata atau median dan 39 albumin diatas rata-rata atau median. Komplikasi pascaoperasi diukur menggunakan Comprehensive Complication Index (CCI), yang mencerminkan seluruh komplikasi pada skala kontinu 0-100, di mana skor lebih tinggi menunjukkan beban komplikasi yang lebih berat. Analisis bivariat dilakukan dengan uji Mann-Whitney untuk membandingkan skor CCI antara kedua kelompok albumin.Hasil: Dari total 78 subjek penelitian, didapatkan nilai tengah albumin 2,85 g/dL. Kelompok dengan albumin <2,85 g/dL memiliki skor CCI lebih tinggi dibandingkan kelompok dengan albumin ≥2,85 g/dL. Analisis menunjukkan hubungan bermakna secara signifikan antara status albumin dan komplikasi pascaoperasi (p<0,05).Kesimpulan: Status pascaoperasi berhubungan signifikan dengan komplikasi pasca pembedahan saluran cerna. Penilaian albumin dapat digunakan untuk mengidentifikasi pasien berisiko tinggi komplikasi dan merencanakan intervensi nutrisi guna mengurangi komplikasi.

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Background: Gastrointestinal surgery carries a high risk of complications, increasing morbidity, mortality, and healthcare costs. Postoperative albumin decline associated with systemic inflammation serves as an important indicator of complications. The Comprehensive Complication Index (CCI) is used to assess complications more comprehensively than the Clavien-Dindo Classification.

Methods: This prospective cohort study was conducted at RSUPN Cipto Mangunkusumo from July to November 2024. The study subjects were adult patients undergoing gastrointestinal surgery. Out of 80 initial subjects, 78 met the inclusion criteria, with 39 in the <2.85 g/dL albumin group and 39 in the >2.85 g/dL albumin group. Postoperative complications were measured using the Comprehensive Complication Index (CCI), which reflects all complications on a continuous scale from 0 to 100, with higher scores indicating greater complication burden. Bivariate analysis was performed using the Mann-Whitney test to compare CCI scores between the two albumin groups.

Results: Among the 78 subjects, the median albumin level was 2.85 g/dL. CCI score in the <2.85 g/dL albumin group significantly higher than the >2.85 g/dL albumin group. These findings indicate a significant association between albumin levels and postoperative complication (p<0.05)..

Conclusion: Postoperative albumin status is significantly associated with gastrointestinal surgery complications. Albumin assessment can be used to identify high-risk patients and plan nutritional interventions to reduce complications."

"Latar Belakang: Pembedahan saluran cerna memiliki risiko komplikasi tinggi yang meningkatkan morbiditas, mortalitas, dan biaya kesehatan. Penurunan albumin pascaoperasi terkait inflamasi sistemik menjadi indikator penting komplikasi. Comprehensive Complication Index (CCI) digunakan untuk menilai komplikasi lebih komprehensif dibanding Clavien-Dindo Classification.Metode:Studi kohort prospektif ini dilakukan di RSUPN Cipto Mangunkusumo pada Juli-November 2024. Subjek penelitian adalah pasien dewasa yang menjalani pembedahan saluran cerna. Dari 80 subjek awal, 78 memenuhi kriteria dengan 39 pada kelompok albumin dibawah rata-rata atau median dan 39 albumin diatas rata-rata atau median. Komplikasi pascaoperasi diukur menggunakan Comprehensive Complication Index (CCI), yang mencerminkan seluruh komplikasi pada skala kontinu 0-100, di mana skor lebih tinggi menunjukkan beban komplikasi yang lebih berat. Analisis bivariat dilakukan dengan uji Mann-Whitney untuk membandingkan skor CCI antara kedua kelompok albumin.Hasil: Dari total 78 subjek penelitian, didapatkan nilai tengah albumin 2,85 g/dL. Kelompok dengan albumin <2,85 g/dL memiliki skor CCI lebih tinggi dibandingkan kelompok dengan albumin ≥2,85 g/dL. Analisis menunjukkan hubungan bermakna secara signifikan antara status albumin dan komplikasi pascaoperasi (p<0,05).Kesimpulan: Status pascaoperasi berhubungan signifikan dengan komplikasi pasca pembedahan saluran cerna. Penilaian albumin dapat digunakan untuk mengidentifikasi pasien berisiko tinggi komplikasi dan merencanakan intervensi nutrisi guna mengurangi komplikasi.

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Background: Gastrointestinal surgery carries a high risk of complications, increasing morbidity, mortality, and healthcare costs. Postoperative albumin decline associated with systemic inflammation serves as an important indicator of complications. The Comprehensive Complication Index (CCI) is used to assess complications more comprehensively than the Clavien-Dindo Classification.

Methods: This prospective cohort study was conducted at RSUPN Cipto Mangunkusumo from July to November 2024. The study subjects were adult patients undergoing gastrointestinal surgery. Out of 80 initial subjects, 78 met the inclusion criteria, with 39 in the <2.85 g/dL albumin group and 39 in the >2.85 g/dL albumin group. Postoperative complications were measured using the Comprehensive Complication Index (CCI), which reflects all complications on a continuous scale from 0 to 100, with higher scores indicating greater complication burden. Bivariate analysis was performed using the Mann-Whitney test to compare CCI scores between the two albumin groups.

Results: Among the 78 subjects, the median albumin level was 2.85 g/dL. CCI score in the <2.85 g/dL albumin group significantly higher than the >2.85 g/dL albumin group. These findings indicate a significant association between albumin levels and postoperative complication (p<0.05)..

Conclusion: Postoperative albumin status is significantly associated with gastrointestinal surgery complications. Albumin assessment can be used to identify high-risk patients and plan nutritional interventions to reduce complications."